The control of antimicrobial resistant organisms within the hospital environment has long relied on the prompt identification of colonized patients and the initiation and maintenance of contact precautions with proper hand hygiene practices. This strategy is founded on the well known fact that the patient's skin is often colonized with these resistant organisms and by avoiding contact with these areas, healthcare workers can disrupt horizontal transmission to other patients. This strategy relies on high compliance with barrier precautions and hand hygiene that is often times difficult to achieve and by its nature is a passive approach to control. In this proposal we intend to study a novel approach to the control of antimicrobial resistant organisms particularly MRSA and VRE. In several pilot studies we have demonstrated that daily bathing of patients with chlorhexidine reduces the incidence of MRSA, VRE, and healthcare associated bacteremias. Daily bathing with chlorhexidine represents an active intervention that reduces the number of resident bacterial organisms on the skin of patients resulting in decreased potential for horizontal transmission. In this proposal, we intend to perform a prospective multi-centered trial entitled "Multicenter evaluation of the effectiveness of source control with daily chlorhexidine skin preparation in reducing nosocomial infections including MRSA and VRE" to determine the possible benefits of daily bathing with chlorhexidine. The proposed study is a joint collaborative effort between McGuire, a consortium of six hospital systems (Johns Hopkins University, Brigham and Women's Hospital, University of Iowa, Memorial Sloan Kettering, Northwestern University and Washington University) and Sage Products, Inc., makers of Comfort Bath washcloths and a new chlorhexidine impregnated washcloth. Both of these products are FDA approved products. Sage has agreed to provide all washcloth products for the interventional trial as well as additional financial support. Funds requested in this proposal will be used to support the coordinating center (McGuire) as well as the necessary statistical, laboratory and economic analysis needed for this large trial. This arrangement represents a unique opportunity for partnership between academic universities, the CDC, and an industry sponsor and will allow for the rapid trial of the possible benefits of chlorhexidine bathing. [unreadable] [unreadable] [unreadable]